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Sequelae of microsporidial keratoconjunctivitis and its management

Amrita Mohanty1, Sanchita Mitra2, Aparajita Mallick2

  • 1Cornea and Anterior Segment Services, Mithu Tulsi Chanrai Campus, L.V. Prasad Eye Institute, Bhubaneswar, Odisha, India.

Indian Journal of Ophthalmology
|May 20, 2021
PubMed
Abstract

Insights

Microsporidia keratoconjunctivitis (MKC) can lead to persistent or recurrent eye disease. Topical tacrolimus ointment shows promise in managing subepithelial infiltrates and preventing recurrence, acting as a corticosteroid-sparing agent.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Microbiology

Background:

  • Microsporidia keratoconjunctivitis (MKC) can present with persistent or recurrent ocular inflammation.
  • Understanding the sequelae and effective management strategies for MKC is crucial for visual recovery.

Purpose of the Study:

  • To characterize the long-term consequences (sequelae) of microsporidia keratoconjunctivitis.
  • To outline and evaluate management approaches for persistent and recurrent MKC.

Main Methods:

  • Retrospective analysis of microbiologically confirmed MKC cases with persistent disease from January 2015 to December 2019.
  • Evaluation of patient demographics, clinical presentations, treatment interventions, and outcomes.

Main Results:

  • Sixteen patients (21 eyes) experienced persistent MKC, with common presentations including superficial punctate keratitis (SPK) and subepithelial infiltrates (SEI).
  • Recurrences were observed in eight eyes, with topical corticosteroids and tacrolimus ointment being common treatments.
  • Visual recovery was significant in persistent cases, but not in recurrent cases, with some eyes developing residual scarring.

Conclusions:

  • Sequelae of MKC are relatively common and can impact visual outcomes.
  • Topical 0.03% tacrolimus ointment appears effective for treating SEIs and preventing recurrence, serving as a valuable corticosteroid-sparing option.
Keywords:
Keratoconjunctivitismicrosporidianon-resolvingpersistencerecurrentsubepithelial infiltratessuperficial punctate keratitistacrolimus

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